Individual
TAMMI LYNN VON WRYEZA-RAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSEDC, LMHC
Contact information
Practice address
2680 GRAND ISLAND BLVD, GRAND ISLAND, NY 14072-1693
(716) 775-7566
Mailing address
2680 GRAND ISLAND BLVD, GRAND ISLAND, NY 14072-1693
(716) 775-7566
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00030241501
UNIVERA
NY
01
—
000506354003
COMMUNITY BLUE
NY
Enumeration date
06/18/2006
Last updated
01/29/2015
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